Patrick Reid extended interview

I’ve been lobbying pretty hard for a long time as both a pharmacist and the CEO of a large aged-care provider for pharmacists to have an extended role within aged care.

We [IRT] were one of the first providers to have a pharmacist on staff, and we’ve seen the many and varied benefits.

I think the main benefit is of course the quality use of medicines aspect for all residents, particularly describing. A lot of people come to us with quite heavy polypharmacy, and so often, particularly around things like antipsychotics and psychotropics, in terms of dementia and other chronic things that people are living with, we find that deprescribing is often of great benefit to the resident.

There are also the benefits of having a pharmacist on staff to help with medicines reviews, to make rounds, and to make sure that they’re optimising the treatment for residents as well.

Onsite pharmacists can also improve coordination with local health services, such as GPs. Many GPs in regional areas have a huge workload, so having someone they can get trusted advice from quickly is incredibly useful.

So, there’s a multitude of benefits from having this process in place.

In terms of the new model, I think the providers should have control over integrating the service in a meaningful way. In the past, it has been the tail wagging the dog. In the RMMR process we were recipients of a service, but we had very little control over how that service was funded, delivered and how it manifested itself on the ground.

The number of RMMRs or reviews that could be done were limited, so that had a lack of utility when we’re talking about some of the most frail and vulnerable people in Australia.

There are 2,500-plus providers in the country, and they operate in very different ways. It’s not going to be cookie cutter. So, you need to find the right pharmacist for that service, and then how best to integrate them to get the best result for residents, staff and other allied health

We often see within the accreditation scheme that medication misadventure ranks in the top three issues that we see within aged care. So, from an accreditation point of view, and also clinical governance, the pharmacist has a very strong role to play there, both in policy and procedure development, but also in the application of those policies and procedures for the safety of the residents.

There are tangible things that can be measured once we have those pharmacists in place. We see that in spades with our pharmacist in terms of the quality of advice when we are developing our policies around medicines and their use, and around how we better streamline some of our services to benefit the resident and reduce risk around misadventure.

Medication management and quality use of medicines is a real challenge and burden for residents and for aged care staff. I think the focus should be on making sure that pharmacists are operating at their full scope. They bring a lot of great skills, particularly to an area where we’re screaming out for allied health and support.

I think we’ll see massive benefits. We’re already seeing it with vaccinations, with pharmacists able to vaccinate in our centres. That’s something I fought for a long time and I’m proud to see the benefits of that now, particularly through COVID and the flu season. Getting pharmacists into aged care sooner rather than later will be a huge benefit to older Australians.

Aged care isn’t just residential aged care – there’s home care as well. Our section 90 community pharmacists do a great job of caring for people in the community.

For a lot of pharmacists, aged care will stretch their skills and allow them to be the health professional that we know they can be. It really will be an exciting time.

To work in this industry, you need empathy. Not everybody is suited to working with this cohort, but it is very enriching. Obviously, pharmacists, in our day-to-day roles in hospital and community, deal with a huge number of older Australians.

The last 3 or 4 years have been incredibly hard in this industry. There are a lot of fantastic people at the front line and within management who are doing fantastic and important work. So, it’s a lovely industry to be a part of, but it’s also a very difficult industry. It keeps me very challenged.

I would suggest pharmacists who haven’t considered it as a career choice, or an operating environment should really give it consideration because it is quite rewarding.